Comparative Study between 3D Echocardiography Right Ventricular -Volumes and Functions- and Invasive RV Quantification in children with valvular pulmonary stenosis pre and post balloon Dilation

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
M Hafez ◽  
H Kamel ◽  
Y Abdelrazik ◽  
H Attia
Keyword(s):  
Pulmonary Stenosis ◽  
Balloon Dilation ◽  
Structural Heart Disease ◽  
University Hospital ◽  
P Value ◽  
Pediatric Age Group ◽  
3D Echo ◽  
Echocardiographic Assessment ◽  
Valvular Pulmonary Stenosis ◽  
And Function

Abstract Aim and objectives The aim of this study was To correlate between 3D echocardiographic assessment of RV volumes and functions with invasive RV quantification by angiography in children with mainly valvular pulmonary stenosis undergoing balloon pulmonary valvuloplasty pre & post balloon dilation, to evaluate the immediate impact of relieving obstruction on RV volumes. Patients and Methods The study included 25 patients in the pediatric age group (up to 18 years old) with Pulmonary valve stenosis referred to our congenital and structural heart disease unit cardiology department in Ain shams university hospital for balloon pulmonary valvuloplasty. All patients were subjected to history taking, clinical examination and ECG recording. Then echocardiographic assessment by 2D and 3D was done to all patients pre and post BPV. All patients were subjected to have pre and post RV angiography for assessment of RV volumes and functions angiographically. Results The study included 25 patients,65% of patients were males and 44% were females, mean of age was 22.79 with range from 2 to 144 months There was statistically significant increase in 3D Echo RV quantification post BPV in comparison to 3D Echo RV quantification pre BPV with RV/EDV(p-value:0.001), RV/ESV(p-value:0.034), RV/SV(p-value:0.002), FAC %(p-value:0.014), TAPSE(p-value:0.001). Also,there was statistically significant increase in angiographic RV quantification post BPV in comparison to angiographic RV quantification pre BPV with EDV(p-value:<0.001), ESV(p-value:<0.001), SV(pvalue:<0.001) and EF %(p-value:<0.001). Conclusion 3DE RV volumes and function shows good correlation and agreement with invasive RV quantification by angiography in children with valvular pulmonary stenosis undergoing balloon pulmonary valvuloplasty.

Unconventional deployment of atrial septal occluder in a patient with atrial septal defect, dextrocardia, and interrupted inferior vena cava

2020 ◽  
Vol 30 (8) ◽  
pp. 1206-1208
Author(s):  
Sreekanth Yerram ◽  
Sunitha Aramalla ◽  
Srinivas Bhyravavajhala
Keyword(s):  
Inferior Vena Cava ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Inferior Vena ◽  
Pulmonary Stenosis ◽  
Balloon Dilation ◽  
Vena Cava ◽  
Atrial Septal Defect Closure ◽  
Deployment Strategy ◽  
Valvular Pulmonary Stenosis

AbstractAn atrial septal defect is a rare anomaly in patients with interrupted inferior vena cava, which renders the percutaneous intervention more complex; and hence, innovative approaches should be sought. Dextrocardia further complicates the procedure, and traditional atrial septal device deployment methods cannot be employed. We report a successful percutaneous secundum atrial septal defect closure by a novel deployment strategy along with balloon dilation of associated severe valvular pulmonary stenosis in a patient with dextrocardia and interrupted inferior vena cava.

Late (Five to Nine Years) Follow-Up After Balloon Dilation of Valvular Pulmonary Stenosis in Adults

1997 ◽  
Vol 80 (2) ◽  
pp. 240-242 ◽  
Author(s):  
Claudius H.J Teupe ◽  
Wolfram Burger ◽  
Rainer Schräder ◽  
Andreas M Zeiher
Keyword(s):  
Pulmonary Stenosis ◽  
Balloon Dilation ◽  
Valvular Pulmonary Stenosis

Experience with balloon pulmonary valvuloplasty and predictors of outcome: a ten-year study

2020 ◽  
Vol 30 (4) ◽  
pp. 482-488
Author(s):  
Sonia A. El-Saeidi ◽  
Hala S. Hamza ◽  
Hala M. Agha ◽  
Mohammed M. Soliman ◽  
Wael A. Attia ◽  
...  
Keyword(s):  
Pressure Gradient ◽  
Pulmonary Valve ◽  
Pulmonary Stenosis ◽  
Cross Sectional Study ◽  
P Value ◽  
Predictors Of Success ◽  
Post Intervention ◽  
Cross Sectional ◽  
Valvular Pulmonary Stenosis ◽  
A Minor

AbstractBackground:Balloon pulmonary valvuloplasty is the treatment of choice for patients with moderate to severe pulmonary valve stenosis.Methods:An observational retrospective cross-sectional study including neonates, small infants, and children who underwent balloon pulmonary valvuloplasty in the period from 2007 to 2016 in the cardiac catheterisation unit of the paediatric cardiology department in Cairo University. Multivariable models were built to report the predictors of the outcome of balloon pulmonary valvuloplasty and its complications.Results:A total of 1200 patients were included in the study and divided according to age into 3 groups: neonates and early infants (n = 282), infants (n = 362), and children (n = 556). Procedural success, defined as a drop pressure gradient across the pulmonary valve to less than or equal to 50% of the baseline measurements, was achieved in 82.7% of the patients. Multivariate analysis revealed that only infundibular pulmonary stenosis (p value 0.032), supravalvular in association with valvular pulmonary stenosis (p value <0.001), and pulmonary valve diameter by angiogram (p value <0.001) were significant predictors of success. The presence of supravalvular in association with valvular pulmonary stenosis (p value <0.001) was associated with a lower weight (p value 0.007) and higher right ventricular pressure before the intervention (p value <0.001), and a minor immediate drop in the pressure gradient post-intervention (p value <0.001) was found to be the most significant predictor of the occurrence of complications.Conclusion:The absence of infundibular and supravalvular stenosis and a large pulmonary valve diameter were the most significant predictors of success.

scholarly journals A Case of William’s Syndrome in a Ugandan Child: A Feasible Diagnosis Even in a Low-Resource Setting

Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1192
Author(s):  
Massimo Mapelli ◽  
Paola Zagni ◽  
Valeria Calbi ◽  
Aliku Twalib ◽  
Roberto Ferrara ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Pulmonary Stenosis ◽  
Sub Saharan Africa ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Sub Saharan ◽  
Valvular Pulmonary Stenosis ◽  
And Function ◽  
Behavior Profile ◽  
And Behavior

Background: Williams–Beuren syndrome (WS) is a rare, complex, congenital developmental disorder including cardiovascular manifestations, intellectual disability and a peculiar cognitive and behavior profile. Supravalvular aortic stenosis (SVAS) is the most frequent cardiovascular abnormality in WS children. Data on WS patients in sub-Saharan Africa are scarce. A genetic study is usually required for a definite diagnosis, but genetic testing is often unavailable in developing countries and the combination of a typical clinical phenotype and echocardiographic profile helps to confirm the diagnosis. Case Report: We report the case of a 5-year-old Ugandan child admitted to a large no profit hospital after he was initially managed as a case of infective endocarditis. A physical examination revealed the typical features of WS. A cardiac echo showed severe SVAS (peak gradient 80 mmHg) with a normal anatomy and function of the aortic valve and mild valvular pulmonary stenosis. The child also had a moderate intellectual disability and a characteristic facies consistent with WS. Conclusion: We present the first reported case of WS in Uganda. Cardiac echo and a characteristic clinical picture could be enough to exclude more common causes of heart failure (i.e., rheumatic heart disease) and to make the diagnosis even when specific genetic tests are not available.

scholarly journals Short-Course Versus Long-Course Colistin for Treatment of Carbapenem-Resistant A.baumannii in Cancer Patient

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 484
Author(s):  
Wasan Katip ◽  
Suriyon Uitrakul ◽  
Peninnah Oberdorfer
Keyword(s):  
Clinical Response ◽  
Cancer Patients ◽  
Therapy Group ◽  
University Hospital ◽  
P Value ◽  
Chiang Mai ◽  
Carbapenem Resistant ◽  
Short Course ◽  
Significant Difference ◽  
Long Course

Carbapenem-resistant Acinetobacter baumannii (CRAB) is one of the most commonly reported nosocomial infections in cancer patients and could be fatal because of suboptimal immune defenses in these patients. We aimed to compare clinical response, microbiological response, nephrotoxicity, and 30-day mortality between cancer patients who received short (<14 days) and long (≥14 days) courses of colistin for treatment of CRAB infection. A retrospective cohort study was conducted in cancer patients with CRAB infection who received short or long courses of colistin between 2015 to 2017 at Chiang Mai University Hospital (CMUH). A total of 128 patients met the inclusion criteria. The results of this study show that patients who received long course of colistin therapy had a higher rate of clinical response; adjusted odds ratio (OR) was 3.16 times in patients receiving long-course colistin therapy (95%CI, 1.37–7.28; p value = 0.007). Microbiological response in patients with long course was 4.65 times (adjusted OR) higher than short course therapy (95%CI, 1.72–12.54; p value = 0.002). Moreover, there was no significant difference in nephrotoxicity (adjusted OR, 0.91, 95%CI, 0.39–2.11; p value = 0.826) between the two durations of therapy. Thirty-day mortality in the long-course therapy group was 0.11 times (adjusted OR) compared to the short-course therapy group (95%CI, 0.03–0.38; p value = 0.001). Propensity score analyses also demonstrated similar results. In conclusion, cancer patients who received a long course of colistin therapy presented greater clinical and microbiological responses and lower 30-day mortality but similar nephrotoxicity as compared with those who a received short course. Therefore, a long course of colistin therapy should be considered for management of CRAB infection in cancer patients.

scholarly journals Diagnostic yield and appropriate indication of upper endoscopy in Jordanian children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eyad Altamimi ◽  
Yousef Odeh ◽  
Tuka Al-quraan ◽  
Elmi Mohamed ◽  
Naif Rawabdeh
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Yield ◽  
Failure To Thrive ◽  
University Hospital ◽  
P Value ◽  
Upper Endoscopy ◽  
Detection Rates ◽  
Common Indication ◽  
Histopathological Findings ◽  
Endoscopic Findings

Abstract Background Upper endoscopy is an essential tool for diagnosing pediatric gastrointestinal issues. This study aimed to assess the indications, diagnostic yields, concordance between histopathological and endoscopic findings and suitability of upper endoscopies performed at a tertiary university hospital in Jordan. Methods Hospital records of children who underwent upper endoscopy were retrospectively reviewed. Demographics, endoscopic details (e.g., indications, findings and any complications), and histopathological findings were collected. The relationship between endoscopic findings and histopathological abnormalities was reported. Results The study included 778 patients (age, 92.5 ± 54.5 months; 380 girls, 48.8%). The most common age group was children younger than 60 months (273 patients, 34.3%). The most common indication for endoscopy was abdominal pain, followed by vomiting and failure to thrive or weight loss. Normal upper endoscopy was reported in 411 patients (52.8%). Age below 60 months, abdominal pain, dysphagia/odynophagia, and heartburn were predictive of abnormal endoscopy in multivariate analysis with p-value 0.000, 0.048, 0.001 and 0.01 respectively. Abnormal endoscopy showed 67.3% sensitivity and 69.9% specificity to predict histopathological abnormalities. Of those performed, 13.6% endoscopies were described as inappropriate indication. The suitability of the procedure was a sensitive predictor for abnormal endoscopic and histopathological findings. Conclusions Abdominal pain is the most common indication for upper endoscopy in our population. It is associated with a higher chance of abnormal endoscopy. Concordance between endoscopic and histopathological findings is not high. Normal endoscopic findings shouldn`t discourage the endoscopist from obtaining tissue biopsies. Considering more biopsies may improve pathological detection rates. Compliance with established endoscopy guidelines may reduce unnecessary procedures.

scholarly journals Interatrial block is related to atrial dysfunction in hypertensive subjects

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
L Tirapu Sola ◽  
F Loncaric ◽  
M Mimbrero ◽  
LG Mendieta ◽  
L Nunno ◽  
...  
Keyword(s):  
Global Longitudinal Strain ◽  
Female Gender ◽  
Left Ventricular ◽  
P Wave ◽  
P Value ◽  
Atrial Remodeling ◽  
Maximal Volume ◽  
Surface Ecg ◽  
Interatrial Block ◽  
And Function

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): La Marató TV3 Background Interatrial block (IAB), a delay of conduction of the sinus stimulus from right to left atria (LA), is defined as surface ECG P-wave duration ≥120 ms. Arterial hypertension (AH) and IAB have been related to development of atrial fibrillation. Aim To investigate the IAB prevalence in a cohort of AH patients and relate it to LA function. Methods 162 patients with well-regulated AT were included. 12-lead ECG were performed and analysed with a digital caliper. 2D and 3D echocardiography were performed, and LA function assessed with speckle-tracking deformation imaging.  Results The median age was 56 ± 6 years, 54% were males. Average duration of AH was 10 ± 6 years. IAB was seen in 25% of AH patients.  The comparison between groups is shown in Table 1. There were no differences in demographic characteristics,  QRS complex duration (p = 0.179) or left ventricular (LV) size and function between subgroups. LA was enlarged in IAB patients, which was coupled with impairment of the LA reservoir strain.  Conclusion Our results show considerable prevalence of IAB in AH patients. The demonstrated LA enlargement and function impairment is not associated with LV dysfunction, therefore suggesting an independent role of IAB in atrial remodeling. Table 1 Interatrial block P value Yes (n= 40) No (n= 142) Age 59 (54-62) 57 (53-61) 0.157 Female gender 16 (40%) 58 (48%) 0.467 Duration of Hypertension (years) 10 (6-12) 8 (5-15) 0.421 Systolic blood pressure (mmHg) 136 (125-150) 136 (127-147) 0.799 Diabetes 3 (8%) 16 (13%) 0.410 LVEDV (mL) 73 (63-91) 71 (57-87) 0.424 E/A 0.98 (0.84-1.25) 0.94 (0.79-1.11) 0.230 E/e’ 7.0 (4.9-8.9) 6.6 (5.2-8.4) 0.779 LVEF (%) 63 ± 7 64 ± 6 0.864 LV global longitudinal strain (%) 21.22 ± 2.63 21.19 ± 2.30 0.932 3D LA maximal volume (mL/m2) 36 (30-39) 30 (26-37) 0.028 3D LA minimal volume (mL/m2) 16 (12-18) 14 (11-17) 0.050 LA reservoir strain (%) 27.64 (24.90-31.23) 29.55 (26.17-32.81) 0.032 LA conduit strain (%) 13.91 (10.71-15.47) 14.37 (11.75-16.72) 0.192 LA contractile strain (%) 14.46 (11.86-16.59) 15.52 (13.66-16.96) 0.079 LVEDV Left Ventricular End Dyastolic Volume

scholarly journals Smoking and associated unhealthy lifestyle behaviours in patients with chronic cardiac diseases during COVID-19 related lockdown

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
F Chague ◽  
M Boulin ◽  
JC Eicher ◽  
F Bichat ◽  
M Saint-Jalmes ◽  
...  
Keyword(s):  
Screen Time ◽  
University Hospital ◽  
Weight Increase ◽  
Phone Call ◽  
P Value ◽  
Time Increase ◽  
Unhealthy Lifestyle ◽  
Lifestyle Behaviours ◽  
Coronary Syndrome ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Dijon University Hospital France OnBehalf CLEO-CD Background   Lockdown can affect tobacco smoking (TS) behaviours.  Purpose To evaluate the impact of lockdown on (TS) and associated lifestyle behaviours in patients with Chronic coronary syndrome (CCS) and congestive heart failure (CHF) Methods CCS and CHF patients were invited to answer to a phone-call questionnaire during the 1st COVID-19 lockdown start  Results (Table) 343 questionnaires were fit for analysis, 43 (12.5%) were current smokers (CS). CS were younger (p &lt; 0.001), none stopped and 13 increased their consumption (main reasons were stress and boredom). CS felt more often cramped (p = 0.023). CS who increased their TS consumption showed a trend toward a higher rate of unhealthy lifestyle behaviours Conclusions During the lockdown, more than ¼ of CS with CCS or CHF increased their TS consumption and none quitted. Moreover, TS was often associated with other deleterious behaviours increasing their risk for short and long term Main results Total Non-Smokers Smokers p* N(%) 344 301 43 Age, years 67.7 ± 12.8 69.2 ± 12.2 57.2 ± 12.1 &lt;0.001 Men/Women 229/115 197/104 32/11 0.300 CCS/CHF 220/124 185/116 36/7 0.004 Urban/Rural 163/181 137/164 26/17 0.073 Living alone at home 83(24.3) 68(22.7) 15(34.9) 0.089 COVID screening (PCR) 11(3.2) 7(2.3) 4(9.3) 0.037 Feeling cramped 19(5.5) 13(4.4) 6(14.0) 0.023 Feeling less well 75(21.9) 65(21.7) 10(23.8) 0.842 K6 ≥ 5 81(23.7) 70(23.5) 11(25.6) 0.845 Physical activity decrease 146(42.6) 125(42.1) 21(48.8) 0.323 Screen time increase 154(45.0) 130(43.5) 24(55.8) 0.100 Alcohol consumption increase 14(5.5) 11(4.9) 3(7.5) 0.419 Sleep change 83(24.6) 68(22.5) 15(39.5) 0.083 Weight increase 77(22.4) 64(21.3) 13(30.2) 0.242 Smokers (n = 43) Smoking increase No smoking increase p** Feeling less well 5(38.5) 5(17.2) 0.238 Screen time increase 10(76.9) 14(46.7) 0.104 Weight increase 6(46.2) 7(23.3) 0.173 n(%) or mean ± SD. *p value: Smokers vs non smokers. **p value: Smoking increase vs no smoking increase

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